Today, there is a distinction made between the two disabilities. Together with this, research findings point to the fact that there is a high frequency of the presence of the two disabilities together, between 15% - 80% (Barkley, 1990, 1994; Mayes et al. 2000).

The dual presence of learning disabilities and ADHD among children is likely to magnify the academic functional difficulty and difficulty in emotional adaptation. The child who has troubles with attention and self-management skills experiences a world lacking calm, lacking organization, full of confusion, inconsistence, exhaustion, and a feeling of being overwhelmed. He, himself, doesn't know how to act in the world around him in order to succeed and receive praise. And even more than this, when he understands what he has to do he has difficulty pulling himself together and being persistent. The gap between his intended goals and the outcomes disappoint him. More than once he reaches the conclusion that he's unsuccessful and lacks a chance.

Alternately, in order to protect himself from feelings of guilt he reaches the conclusion that his parents and the adults around him are those that are unfriendly and don't understand.

1. The daily proceedings at home and in school are difficult and overwhelming for them and those around them and are full of crises.

2. In order to bring the child to appropriate functioning, he's in need of understanding, direction, supervision, and reliance on the management skills of those around him.

3. Behavioral failure doesn't come from the outset from a lack of motivation, but rather from a real difficulty to restrain him and to supervise his behavior.

4. The problems in attention and management skills influence all areas of life: academic, behavioral, and social. Problems that arise in all of these areas should be addressed.

The Realization of the Lasting Existence of the Disability

There is a direct and central connection between the understandings of the child of what is not "normal" with him to his ability and desire to deal with the difficulty. When he understands how the attention and self-control systems function, what helps him and what causes him to fail, then he'll be more willing to get into routines and external rule structures that for him may be perceived as something he is being forced to accept. It is important to explain to the child on a level that is appropriate to his understanding and to the parents, which specific system is weak for him.

Supervision Over Rest, Sleep, and Diet

Attention processes are directly influenced by situations of lack of sleep and unbalanced division of time between sleep and being awake. Children that exhaust themselves for hours in front of the computer and television; that go to sleep at late hours or have interrupted sleep, have difficulty afterwards to gather enough mental energy to learn.

Also, disorderly patterns of eating that are spread across the entire day with all sorts of food has an impact on vitality and awareness.

Introducing healthy, orderly living habits increase the ability to prolonged effort and to focusing attention on learning tasks when these are required.

Constructing a Routine and Daily Schedule

Children with ADHD have a different biological clock and times when they are more awake and alert. Most of the day the child has to accommodate himself to his surroundings, but at times it is possible to alter the surroundings for the child.

It's better to do homework at the best time for the child. A short rest after school and then doing homework allows the child to do what's being required of him before he gets tired and absorbs excess stimuli from computer games and television.

Parental Presence/or an Important Adult Other

The difficulty to find the strength for learning is even more when the child is found alone. The failed attempts to gather energy and to persist until reaching the desired goal build up and bring to despair from the outset.

In the presence of an adult, the wish to learn in order to make the adult happy and to receive from him appreciation and admiration help to regulate the motivation and alertness. Many children are stubborn that at least one parent will sit by them when they're doing their homework. Afterwards, the adult can gradually decrease his presence: to sit by and to encourage him, to sit in the area like in the same room and to be busy with something else, to peak in on the child every couple of minutes and to offer encouragement, etc...

A Secure and Loving Learning Environment

A child with ADHD needs a secure and loving environment, only in this type of environment he can take chances and deal with academic requirements and failures.

In order that he will succeed to develop concentration and self-management skills, he's in need of an adult to whom he can turn when it's hard for him and who will help him to regulate himself effectively. Minimal corrections and criticisms and reduction of reproof and moral preaching, these are the guarantee for keeping positive relations and a supportive routine.

Making a Routine of Giving Rewards and an Opportunity to Vent

It's important to make the giving of encouragement and rewards part of the routine, structured framework. The more that the expectations are clearer, the less there are frustration and anger; the more that the offering of emotional and physical support are more secure and fixed, the doubt and fear that something may be missing become less. The stipulation of giving rewards for the behavior of the child causes him, not to be sure that the rewards will actually be given.

Rewards Program

In order that rewards programs will be effective, they have to be consistent, and the reward must be given soon after the required performance. The reward should be small but attractive enough and not bargainable. Offering an incentive that is too big just increases the inner conflict, agitation, overburden, anger, and frustration when he doesn't receive the reward. The rewards are given for finishing specific assignments and making certain accomplishments. A clear and positive explanation for how one receives a reward is important. In order that the rewards program will be effective it must be consistent and the reward given in close proximity of time to the requested action.

Using the Child's Repertoire

When there's an attraction to certain, familiar content and a preference to focus on a well-liked subject and to drain it out, it's worthwhile to start building a connection and learning by means of the liked subject. Gradually, it's possible to expand and vary the repertoire and to add other content. Observe the child at the time of his/her free play and ask the parents about his preferred activities at home. They can give the teacher a clear idea of what interests the child.

Assistance in Organization and Planning

It's possible to assist in getting organized by means of instilling a set routine behaviors that are performed at set times according to a written list or a preparatory list which can be recalled by memory. Children that are successful at internalizing and getting used to writing in a daily schedule book, to prepare a page of tasks, and also to remember to follow after it, improve their ability to get organized in a considerable manner.

Assistance in Enlisting and Maintaining Attention

In prolonged conversation or activity, when the stimuli change and are not consistent, they lose their focus and tend to retreat inside themselves and to immerse and concentrate on inner topics, or alternatively to be distracted by every external stimulus.

It's necessary to remind them periodically to pay attention to what's going on, to make sure they're participating in review of the regular activities and in the topic of conversation. When it's seen that they're disengaged, it's worthwhile to catch their attention, to repeat in short on the main topic of the conversation and to include them again in what's being done by means of a question or doing a task. When the child sits close to the teacher, it's technically easier to make sure periodically that the child is paying attention.

Prefacing Difficult Learning Material

New and difficult learning material should be taught with a preface and to be taught individually before it is taught to the entire class. The earlier exposure to the new ideas allows better integration in the group and the ability to follow after the material and to participate actively.

The preface is particularly appropriate for texts from the Tanach or literature in which there are many new words, complicated sentences, and hinted ideas.

Learning in a One-on-One Situation

It's important to integrate during the day situations where the child can learn one-on-one, when the instruction is customized to his pace and focuses on him. Individual learning improves understanding and helps relax from the feeling of being overwhelmed by stimuli and from the constant changing of activities in the classroom setting. When there's not an opportunity to teach in an individual way, then the child can be directed to a computer or work table on the side where he can rest or work on something familiar.

Exercises and Compensation Strategies

In order to allow successes and to minimize failures, one should organize the home and learning environment in an appropriate way. M. Levin (1999) lists relevant intervention strategies for strengthening attention and management systems. The more a child has an understanding of his problems and he cooperates with these programs out of understanding of their urgency and role:

• Sitting close to the teacher in class should help the student remain alert and to minimize distractions
• Train the child in building plans and time schedules at home and at school. A list of goals, estimation of time, daily plan, appropriate amount of time allotted.
• Division of each activity in class, at home, preparing homework assignments in short tasks with breaks for rest; encouragement and strengthening on every task; giving praise when a child succeeds in maintaining attention.

Conversations with the child how he feels when he becomes tired and he doesn't have any more strength to think; helping the child do each task in the easiest way possible, spending too much energy leads to a feeling of hopelessness and not to challenge.

Summary

The parents of these children must enter the role of the advocate of the child, to represent the child in the educational settings and to demand a response to the variety of his needs. Minimize and adjusting the requirements to the needs of the child on the one hand and real supervision on his meeting the requirements from the other hand will allow him to turn his good intentions to successful results.

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